The Investigation Of Anxiety And Depression In Heart Failure Patients

Background: There are many investigations of great samples showed that thereexists high prevalence of anxiety or depression or both in the patients ofcardiovascular diseases from many countries. But it's lack of datas about heart failurepatients in this field. We aimed to know how was the situation of anxiety anddepression in the heart failure patients in our investigations, and we investigated thedoctors' opinions about these patients as well. Meanwhile we tried to make a contrastof the self-rating scales of anxiety and depression between SASSDS and HADS.Methods: In the first part we had the patients with heart failure symptomsfinished the SAS/SDS scales. We explained the options of the scales to the patients ifneeded. In the second part, none heart failure patients were included as well as heartfailure patients, and two kinds of scales, SASSDS and HADS were randomlydistributed to patients, we didn't explain any options of the scales to help patientsfinished them at the first place, then the scales were distributed back to patients againif it's unfinished or blank and this time we explains any options if needed to madesure the scales were 100ï¼…finished. In the third part, we investigated the doctorswho's taking charge of the patients of the second part.Result:The first part: 112 heart failure patients were included, 20.5ï¼…had anxiety,30.4ï¼…had depression. The statistic significance existed between gender, NYHA,cardiovascular diseases family history, blood group, length of stay, level ofCRP/hsCRP/NT-proBNP and the scores of SAS/SDS.The second part: Altogether 256 patients were included. Rate of anxiety was26.2ï¼…, rate of depression was 24.2ï¼….The rates of anxiety/depression in HADS were significantly higher than inSASSDS, (anxiety: 38.1ï¼…vs 16.8ï¼…, depression: 31ï¼…vs 18.9ï¼…). More SASSDSscales needed secondly refilled. There's no significant difference between SAS scoresand the SAS norm of Chinese, indicating that the patients of this investigation intended to select the options less severe than the real situation. In the logisticregression analysis, taking anxiety or not as the dependent variable, there left the typeof rating scales(SASSDS or HADS) and NYHA classification in the regressionequation as the independent variables; taking depression or not as the dependentvariable, there left only the NYHA classification in the equation.The rates of anxiety/depression in heart failure patients were significantlyhigher than none heart failure patients, (anxiety: 32.5ï¼…vs 20.0ï¼…, depression: 31.7ï¼…vs 16.9ï¼…). The risk ratio (RR) of heart failure versus none heart failure patients ofanxiety was 1.929(1.092, 3.408); RR of depression was 2.283(1.263, 4.129). NYHAâ…¢andâ…£patients had severer anxiety/depression situations than NYHAâ…¡and there'sno difference between NYHAâ…¡andâ… . There's significant Spearman relationshipbetween the scores of anxiety/depression and NYHA classification. In the logisticregression analysis, taking NYHA lighter group (NYHAâ… +â…¡)/NYHA severegroup(NYHAâ…¢+â…£) as the dependent variable, there finally left anxiety/depressionor not, Big-ET levels, NT-proBNP levels in the regression equation as the independentvariables.In none heart failure patients group, HADS was more sensitive indiscovering anxiety/depression when compared with SASSDS. In the heart failuregroup, HADS was more sensitive in discovering anxiety but not depression. Thereboth existed significant rank correlations between NYHA classification andanxiety/depression scales' scores in the HADS group or SASSDS group.To the same patient, anxiety score is significantly correlated with depressionscore. Comorbid anxiety and depression is a common phenomenon.There were less variables connected with HADS anxiety/depression scoresthan with SASSDS scores, indicating that the results from SASSDS are more specificthan results from HADS though HADS is more sensitive in discoveringanxiety/depression.The third part: Altogether 92 copies of the doctor's evaluation charts werecollected. According to the doctor's evaluations, 59.8ï¼…of the patients had obviousanxiety, 37.8ï¼…had obvious depression. 66.7ï¼…of those anxiety/depression were thought by the doctors to be normal phenomenon accompanied with thecardiovascular diseases required no need to be treated with. This might be one of thereasons causing the very low rate of antidepressive or antianxiety treatments in clinic.The observations of patient's sleep, character, collaborate with staff, relationship withvery close relatives could help doctors assess if the patient has anxiety/depression.There were lack of connection and consistency between doctors' assessment andSASSDS or between doctors' assessment and HADS. But as to the generate rate ofdepression, in the NYHAâ…¢+â…£group, the three ways(doctors' assessment, HADS,SASSDS) carried out the same results of 38.1ï¼…. To the generate rate of anxiety,different ways gave different results in different groups of patients.Conclusion: There existed severer anxiety/depression situations in heart failurepatients than none-heart-failure cardiovascular diseases patients. It's an urgentproblem to find a standard procedure to discover and define anxiety/depression incardiovascular diseases or heart failure patients.